What is rejection sensitive dysphoria (RSD)?
Rejection sensitive dysphoria (RSD) is when a person feels intense emotional pain related to rejection. The word “dysphoria” comes from an ancient Greek word that describes a strong — if not overwhelming — feeling of pain or discomfort. Though RSD isn’t an officially recognized symptom or diagnosis, it’s still a term that experts use in connection with recognized conditions.
While rejection is something people usually don’t like, the negative feelings that come with RSD are stronger and can be harder to manage or both. People with RSD are also more likely to interpret vague interactions as rejection and may find it difficult to control their reactions.
What’s the difference between rejection sensitivity and rejection sensitive dysphoria?
RSD and rejection sensitivity are closely linked, but there are subtle differences. To understand the differences, it helps to first know about an issue known as emotional dysregulation.
What is emotional dysregulation?
The human brain has an elaborate network of connections between its different areas. Those areas have different jobs, with some areas managing memories, emotions, input from your senses, etc. As you get older, your brain learns to regulate those signals, keeping them at manageable levels. This is much like the volume control on a TV when it keeps the sound at levels you find comfortable.
Emotional dysregulation happens when your brain can’t properly regulate the signals related to your emotions. Without that ability to manage them, it’s as if the TV volume control is stuck at a disruptively or painfully high level. In effect, emotional dysregulation is when your emotions are too loud for you to manage, causing feelings of being overwhelmed, uncomfortable or even in pain.
Emotional dysregulation can happen with many conditions, especially those affecting your brain’s structure or how it processes information. It happens commonly with personality disorders, mood disorders and more.
Emotional dysregulation and rejection sensitivity
Emotional dysregulation happens with both rejection sensitivity and RSD. Dysphoria doesn’t.
People with rejection sensitivity can do one or more of the following:
Feel severe anxiety or other negative emotions before an anticipated rejection.
Have trouble seeing nonpositive interactions (such as neutral or vague reactions) as anything but rejection and react accordingly.
Overreact to feelings of rejection, leading to behavior that reflects negative emotions like anger, rage, extreme sadness, severe anxiety, etc.
While all of those are also possible with RSD, there’s one more component: People with RSD describe feeling an intense — if not overwhelming — level of emotional pain.
What are the symptoms of rejection sensitive dysphoria?
As mentioned, the key symptom of RSD is intense emotional pain. That pain usually has to be triggered by rejection or disapproval. However, people with RSD often have difficulty describing what it feels like because it’s so intense and unlike most other forms of pain (emotional or otherwise).
People with RSD often show the following traits and behaviors:
It’s very easy for them to feel embarrassed or self-conscious.
They show signs of low self-esteem and trouble believing in themselves.
They have trouble containing emotions when they feel rejected. This is often noticeable in children and teenagers with this condition. Some may react with sudden shows of anger or rage, while others may burst into tears.
Instead of losing control of their emotions outwardly, some people with RSD may turn their feelings inward. This can look like a snap onset of severe depression, and sometimes, it’s mistaken for sudden emotional shifts that can happen with bipolar disorder or borderline personality disorder.
They’re often “people pleasers” and become intensely focused on avoiding the disapproval of others.
They may avoid starting projects, tasks or goals where there’s a chance of failure.
They compensate for their fear of failure or rejection by going all-out or striving for perfectionism. However, the downside of this is that they often experience intense anxiety and may not easily make self-care or downtime a priority.
What causes rejection sensitive dysphoria?
Experts aren’t sure exactly why RSD happens. But they suspect it involves issues with the structure of your brain and that it happens for similar reasons as ADHD.
Researchers do know that social rejection — even when it’s vague or uncertain — causes similar brain activity to pain. They also know that the brain of someone with ADHD doesn’t regulate internal communication the same way as the brain of someone without ADHD. The brain areas that filter and regulate signals aren’t as active. This means there’s less of a filter on brain activity.
This difference in regulating internal communication is why people with ADHD commonly have trouble processing information from their senses. It also makes them prone to feeling overwhelmed by loud noises, bright lights or sudden changes in what’s happening around them. The brain of someone with ADHD might not be able to regulate pain-like activity, which would explain why rejection is so much more troubling and painful to someone with RSD.
Genetic connections
ADHD is a condition that has a genetic component, which means it commonly runs in families. Likewise, RSD — which has strong links to ADHD — is also more likely to have a genetic link.
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